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Background: Periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) is a substantial health issue with a high mortality rate. Inflammation and oxidative stress are major contributing factors to PMI. Allopurinol inhibits xanthine oxidase (XO)-induced oxidative stress and has potential cardiovascular benefits. Methods: This randomized clinical trial evaluated 110 patients admitted to elective PCI. Patients were assigned to receive either a 1200 mg loading dose of allopurinol 2 hours before the procedure (n = 55) or the standard pretreatment (n = 55). The creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) levels were measured in both groups at the baseline, 8, and 24 hours after PCI. Results: There were no significant differences in the CK-MB levels at baseline (P = 0.71), 8 (P = 0.26), and 24 hours (P = 0.88) after PCI between the two groups. No significant changes in the cTnI levels at baseline (P = 0.26), 8 (P = 0.80), and 24 hours (P = 0.89) after the PCI were also noted. The mean difference for CK-MB and cTnI changes was not different between the two groups. Conclusion: Our study revealed that allopurinol did not reduce cardiac-specific enzymes. Further studies are required to evaluate the impact of allopurinol on preventing PCI-related myocardial injury.

Background: Considering the potential benefits of colchicine in coronary artery diseases, we aimed to carry out the present study to assess the impact of colchicine in the prevention of myocardial injury following elective percutaneous coronary intervention (PCI). Methods: A randomized, single-blinded, clinical trial was carried out on 102 patients undergoing elective PCI. All patients received the standard treatment prior to performing PCI. Moreover, the intervention group received 1, 0.5, 0.5 mg colchicine 12 to 18 hours before, 30-60 min before, and 12 hours after PCI, respectively. Serum concentrations of cardiac troponin I (cTnI) were measured before, 8, and 24 hours after the procedure to assess myocardial damage during PCI. Results: There were no significant differences in cTnI levels at baseline (P = 0.839), 8 (P = 0.729), and 24 hours (P = 0.398) after PCI between the intervention and the control groups. Likewise, no significant differences were seen regarding the mean differences of cTnI at baseline and 8 hours (P =0.190), at baseline and 24 hours (P = 0.780), and 8 and 24 hours after PCI (P = 0.680) in both groups. Conclusion: The study did not support the potential benefit of colchicine in the prevention of myocardial injury following elective PCI. Conducting well-designed randomized clinical trials with adequate sample size is recommended.

Background: Given the potential anti-ischemic effects of allopurinol, we aimed to assess whether allopurinol administration may reduce myocardial injury following non-ST elevation myocardial infarction (NSTEMI). Methods: A randomized clinical trial (RCT) was conducted on 100 individuals with NSTEMI.The intervention group (n=50) received 600 mg oral allopurinol at the time of diagnosis ofNSTEMI, followed by 300 mg every day for two next days and the standard treatment of NSTEMI, while the control group (n=50) received only the standard treatment. Serum concentrations of cardiac troponin I (cTnI) were measured at baseline, and 8, 16, 24, and 32 hours after the treatment. Results: The baseline demographic and clinical data of the patients were not statistically different between the intervention and control groups (all P > 0.05). The comparing estimated marginal mean ± standard error for cardiac troponin I (cTnI) levels revealed no significant difference between the study groups (2.93 ± 0.27, 2.25 ± 0.27; P=0.082). The linear mixed model results showed that the interaction of time and group was not statistically different (P=0.751). Moreover, there was a decreasing trend over time for cTnI in both groups (P=0.039). Conclusion: The present pilot RCT did not support the potential cardio-protective benefits of allopurinol administration on decreasing myocardial injury following NSTEMI.

Background: Medication errors (MEs) frequently occur in intensive care unit (ICU) admittedpatients. The present study aimed to evaluate the frequency and types of MEs in an open heartsurgery heart ICU and clinical pharmacists’ role in the management of them. Methods: This cross-sectional, observational study was performed from October 2016 toMarch 2017 in the Shahid Madani Heart Center. A clinical pharmacist reviewed patients’ files,laboratory data, and physician orders during morning hours. All of the MEs and the clinicalpharmacies’ recommendations for the management of them were analyzed. Results: A total of 311 MEs were observed in the medical files of 152 patients. The rate of MEswas 2.04 errors per patient and 0.19 errors per ordered medication. The acceptance rate of MEswas 72.6%. The most type of MEs was ‘forgot to order’ (75 cases, 24.1%) followed by "wrongfrequency" and "adding a drug" in 56 (18%) and 49 (15.8) patients, respectively. Most MEs wereinsignificant. Conclusion: MEs occur at different stages of the therapeutic process in the postoperative cardiacintensive care unit, and clinical pharmacists play an essential role in detecting and managingMEs.

Background: Pentoxifylline (PTX) is a xanthine derivative with the potential cardiovascular effects. This study was done to evaluate the impact of pentoxifylline on blood pressure when added to patients’ antihypertensive regimen. Methods: A randomized control trial were carried out on 100 patients with primary hypertension for a three-month period. The intervention group received 1200 mg daily PTX in three divided doses plus the standard treatment of antihypertensive medications, whereas the control group received only the standard treatment of hypertension. Patients’ blood pressure was measured at baseline, 4, and 12 weeks after intervention. Patients were also followed up for major adverse cardiac events. Results: After 4 weeks and 12 weeks of study, no significant difference was observed in systolic blood pressure (SBP) (135 ± 16 vs. 136.2 ± 17.2 mmHg, p=.72; 134.8 ± 13.3 vs. 134.3 ± 14.7 mmHg, p=.85) and diastolic blood pressure (DBP) (81.5 ± 9.9 vs. 82.4 ± 12.9 mmHg, p=.69; 80.8 ± 9 vs. 80.4 ± 10.7 mmHg, p=.84) between two groups. Conclusion: The result showed that PTX has not a significant effect on BP in patients with primary hypertension.

Background: Drug utilization review is defined as an authorized, structured, ongoing review of prescribing, dispensing and use of medication. Vancomycin is a narrow-spectrum glycopeptide anti-infective with activity against many gram-positive organisms such as Staphylococci, group A

Background: Considering the high prevalence and risk of Deep Vein Thrombosis (DVT) and pulmonary thromboembolism (PTE) in hospitalized patients and the existence of different prophylaxis methods in these patients, the necessity of evaluating the rational administration of heparin or enoxaparin and mechanical prophylaxis is one of the important priorities. The present study aimed to evaluate the consistency of the Heparin/Enoxaparin administration in comparison to guidelines in patients admitted to Imam Reza Hospital. Methods: In this prospective study drug use evaluation (DUE), 300 hospitalized patients receiving venous thrombosis prophylaxis were enrolled, of which 150 patients were selected from surgical wards and 150 patients from internal wards. The demographic and clinical data of patients were collected using clinical records of them. We used the checklists based on the Geneva System for patients admitted to internal wards and the Caprini Questionnaire for patients in surgical wards to evaluate whether patients had received heparin/enoxaparin prophylaxis and mechanical DVT prevention according to guidelines. Results: In the surgical ward, prophylactic treatment for venous thrombosis was administered in 85 (56.6%) patients admitted to surgical wards in accordance with the clinical guideline and in the internal ward, in 42 (28%) patients, with a significant difference between two sections (P: 0.0001). Mechanical prophylaxis, including compressive socks, was performed in 99 (66%) patients in the surgical ward and in the internal ward only in 56 (37.4%) patients, according to the guideline. Drug prophylaxis was administered in surgical wards in 116 (77.3%) patients and in internal wards, in 79 (52.6%) patients according to the guideline.Conclusion: Intravenous thrombosis prophylaxis, according to the guidelines, is more common in patients admitted to surgical wards than in internal wards. But in both sectors, statistics are far from international standards.

Background: The respiratory distress syndrome (RDS) is a common pulmonary disorder that usually occurs as a result of preterm labor and is associated with lack of surfactant. The aim of this study was to evaluate the pattern of surfactant prescription in Alzahra teaching hospital in Tabriz, Iran. Methods: This drug use evaluation (DUE) study was conducted in the neonatal intensive care unit (NICU) of Al-Zahra Hospital, Tabriz, Iran. The demographic and clinical data collection was performed using clinical records of patients. The pattern of surfactant replacement therapy was evaluated and compared with the European Consensus Guideline on the management of respiratory distress syndrome in 2016. Results: A total of 252 premature infants who received surfactant between August 2017 and March 2018 were included. 80.8% of neonates were born by cesarean section. The most used surfactant was Curosurf®, which was used in 82.1% of cases. Only 34.9% of the infants received within 8 hours of birth. Moreover, 79% of infants received the standard dose of surfactant, while 9.5 % and 11.5% were given high and low doses of surfactant, respectively. Conclusion: The pattern of surfactant replacement therapy was not completely according to the guidelines, particularly regarding the time of administration. Considering the importance of dose and timely administration of surfactant, providing strategies to decrease these errors are important.

The coronavirus disease 2019 (COVID-19) outbreak has caused a public health crisis worldwide. However, data regarding the protective factors of the disease is limited. Consequently, preventive health measures that can decrease the risk of infection, progression, and severity are dreadfully required. It is well-documented that people with immunodeficiency, such as the elderly, people who already have comorbidities (e.g., diabetes mellitus, hypertension, respiratory and cardiovascular disorders), and underrepresented minorities, are placed in a group with a higher risk of getting infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A diet rich in vitamins, minerals, and antioxidants plays an essential role in strengthening the immune system and fighting against invading pathogens. The present comprehensive review has discussed published literature regarding the potential role of vitamins in strengthening the immune system and managing viral infections, particularly SARS-CoV-2 infection. Although there are controversial data regarding the plasma level of vitamin D and the severity of the disease, according to the limited evidence, vitamin D may lower the mortality rate. Moreover, vitamin C could reduce the development of inflammatory response; however, the results of ongoing clinical trials are required to confirm these primary findings.